中华护理杂志 ›› 2025, Vol. 60 ›› Issue (17): 2141-2144.DOI: 10.3761/j.issn.0254-1769.2025.17.015

• 疑难重症护理 • 上一篇    下一篇

1例老年患者行二尖瓣置换术后并发Takotsubo综合征的护理

古晓林(), 张崇健, 曾丽若, 李杰, 陈玉琴()   

  1. 510080 广州市 南方医科大学附属广东省人民医院(广东省医学科学院)心外重症监护二科(古晓林,张崇健,曾丽若,李杰),综合一区(陈玉琴)
  • 收稿日期:2024-10-29 出版日期:2025-09-10 发布日期:2025-08-29
  • 通讯作者: 陈玉琴,E-mail:chenyuqin@gdph.org.cn
  • 作者简介:古晓林:女,本科,护师,E-mail:guxiaolin@gdph.org.cn
  • 基金资助:
    广东省医学科学技术研究基金(A2024677)

Nursing care of Takotsubo syndrome in an elderly patient after mitral valve replacement surgery:a case study

GU Xiaolin(), ZHANG Chongjian, ZENG Liruo, LI Jie, CHEN Yuqin()   

  • Received:2024-10-29 Online:2025-09-10 Published:2025-08-29

摘要:

总结1例老年患者行二尖瓣置换术后并发Takotsubo综合征的护理经验。护理要点:密切监测心电图与心肌酶谱变化,早期识别Takotsubo综合征;采取多元协同循环支持策略,保护心肌功能;实施“环境-沟通-家庭支持”心理干预,预防Takotsubo综合征恶化;开展早期康复干预,缩短机械通气时间。经过精心的治疗与护理,术后第12天,患者左心室射血分数恢复至46%,未发生恶性心律失常或多器官功能障碍,术后第16天患者转入普通病房继续治疗,术后第22天康复出院。

关键词: 二尖瓣置换术, 老年人, Takotsubo综合征, 护理

Abstract:

This study summarizes the nursing experience of an elderly patient who developed Takotsubo syndrome following mitral valve replacement surgery. Key nursing points include:close monitoring of electrocardiogram and myocardial enzyme spectrum changes for early identification of Takotsubo syndrome;implementation of a multi-dimensional collaborative circulatory support strategy;establishment of a triadic psychological intervention model comprising “environment-communication-family support” to prevent the exacerbation of Takotsubo syndrome based on stressor management;application of multimodal early rehabilitation interventions to shorten mechanical ventilation duration. After meticulous treatment and care,the left ventricular ejection fraction (LVEF) of the patient improved to 46% on postoperative day 12. There were no occurrences of malignant arrhythmias or multiple organ dysfunction. On postoperative day 16,the patient was transferred to a general ward for continued specialized treatment,and on postoperative day 22,the patient was successfully discharged after rehabilitation.

Key words: Mitral Valve Replacement, Aged, Takotsubo Syndrome, Nursing Care